亚低温对重型颅脑损伤患者S100B蛋白和D-二聚体含量的影响及其意义

目的观察亚低温对重型颅脑损伤患者S100B蛋白和D-二聚体含量的影响及其临床意义。方法 56例重型颅脑损伤患者,随机分为亚低温组和对照组,亚低温组采用32~34℃低温治疗,对照组采用常温治疗,观察两组患者入院第1,2,3,5 dS100B蛋白和D-二聚体含量的变化,比较两组患者出院后3月随访的Glasgow预后评分（GOS）。结果亚低温组患者S100B蛋白和D-二聚体含量在第2,3,5 d时明显低于对照组（P〈0.05）,出院3月后随访GOS比较,两组患者在恢复良好评分（≥5分）和植物生存及死亡（1~2分）比较差异明显。结论亚低温能有效抑制颅脑损伤后的高凝状态,降低脑组织代谢和耗氧量,抑制内源性脑损伤因子是可能的脑保护机制。

Changes and Clinical Significance of S-100B Protein and D-Dimer in the Patients with Severe Brain Injury on Subhypothermia Treatment

Objective To observe the changes and clinical significance of S-100B protein and D-Dimer in the patients with severe brain injury on subhypothermia treatment.Methods Fifty-six patients with severe brain injury were randomly divided into two groups： subhypothermia group（32～34℃,n=28） and control group（common temperature,n=28）.Changes of S-100B protein and D-Dimer in both groups were detected on the first,second,third and fifth day after the treatment in hospital.Glasgow Score was compared in the two groups 3 months after discharge.Results S-100B protein and D-Dimer content in subhypothermia group were obviously lower than those in control group on the first,second,third and fifth day after the treatment（P〈0.05）.Compared with Glasgow Score of 3 months after discharge,there were obvious differences in recuperation score（≥5） and vegetative existence and death（1～2）.Conclusion Subhypothermia treatment could actively suppress hypercoagulable states after craniocerebral injury,decrease brain tissue metabolism and oxygen consumption,so it is the possible mechanism of brain protection to inhibit endogenous brain injuries factor.